呕吐者，胃火也。胃火上冲，呕吐而食不下咽。咳逆者，肺火也。肺火上冲而咳逆不止也。《经》云∶
呕吐者，邪甚于上。顺其气，清其火，则自止矣，切勿用姜汁，有痰在膈，在经络非
吐不可，吐中亦有发散之义，《经》所谓∶因其高者因而越之也。
呕吐不止者，用葛根煎汁服之，不能下气消痰。呕哕不止者，用枇杷叶煎服之，能止痰嗽咳逆。
渴而每饮为上消，肺热也，心火移热于肺。多食善饥为中消，胃热也。渴而小便数，且有膏为下消，肾热而水亏也。
人以胃气为主，不食则胃气必伤，此为实热壅塞而然也。回
后重用石膏以清胃火，大便秘结须加大黄，不忧寒凉太过，不忧荡涤伤胃，《经》云∶百凡欲食最为先。《
经》云∶安谷则昌，绝谷则亡。不食应知各有缘，有热邪犯胃而不食也，亦有胃虚火闭不食者，此则火闭无疑
非胃虚也。胃虚不食身安静，胃热人烦体自炎外。又有饮食过多，或痰凝气滞，与夫寒邪闭塞胃热者，
皆令不食，须知其食过多，致脾不消谷而成痞胀者有之。
热毒犯心，心为君主，忽被风邪束缚，不得汗泄，大小肠郁结不得内行，是以心火亢极，金受火克，不
得平木，木动风生以侵脾土，故吐食更兼搭眼，面青又见头摇，气乱神昏，遂生惊搐之症。《经》云∶木邪盛
而伤土，宜发散兼利小便，使其内外之毒，分消而惊搐自定，发散用消毒饮加防风、川羌、煨天麻、木
通、小草、甘草、钩丁、陈皮、青皮。回后加大黄、麦冬、柴胡、山栀，或用清解散。防风、荆芥、蝉衣、桔
梗、前胡、川芎、升麻、黄芩、木通、大力、连翘。治法当平肝木，利小便为要。泻肝则风去，利小便则心热
清。此因心火火炽盛，肺金受克不能制肝木，以致火风相搏，神不得安，邪火退，正火旺，则心
肝宁而惊搐定矣。发搐惟利关节，毋为惊治，须清烦热安神治，宜疏风消食透毒为良。
呕吐，是由胃火引起的。胃火上冲，导致呕吐且食物无法咽下。咳逆，是由肺火引起的。肺火上冲，导致咳嗽和气逆不止。《黄帝内经》说：呕吐是邪气盛于上部。顺应其气机，清除火热，症状自然停止，切勿使用姜汁。如果膈部或经络中有痰，必须通过催吐排出，因为催吐中也包含发散的含义，《黄帝内经》所说的“因其高者因而越之”（病位在上，用涌吐法使邪气从上而出）就是这个意思。
呕吐不止的，服用葛根煎煮的汁液，但不能降气消痰。干呕呃逆不止的，服用枇杷叶煎剂，能止住痰嗽和咳逆。
口渴且每次饮水较多的称为上消，属于肺热，是心火移热于肺所致。食量多且容易饥饿的称为中消，属于胃热。口渴且小便频数，尿液中有膏脂样的物质，称为下消，属于肾热而肾阴亏虚。
人以胃气为本，不进食则胃气必然受损，这是由实热壅塞造成的。后期重用石膏以清泻胃火，大便秘结须加大黄，不必担忧寒凉药性太过，也不必担忧攻下药损伤胃气，《黄帝内经》说：“百凡欲食最为先”（能够进食是最重要的）。《黄帝内经》又说：“安谷则昌，绝谷则亡”（能消化食物则生机旺盛，不能消化食物则生命危亡）。不吃饭应该知道各有原因，有的是热邪犯胃导致不食，也有的是胃虚火闭导致不食，这种情况无疑不是胃虚。胃虚导致的不食，身体安静；胃热导致的不食，人体烦躁且体表发热。又有饮食过多，或者痰凝气滞，以及寒邪闭塞导致胃热的情况，都会导致不食，需要知道饮食过多导致脾不运化水谷而成痞满胀气的情况也是存在的。
热毒侵犯心脏，心为君主之官，忽然被风邪束缚，汗液不得宣泄，大小肠郁结导致邪气不能向内运行，因此心火亢盛到了极点。肺金受火克制，不能平抑肝木，肝木妄动生风以侵袭脾土，所以出现呕吐食物并伴有眼睑跳动、面色青紫、头部摇动、气乱神昏，于是产生惊搐的症状。《黄帝内经》说：木邪盛而伤及脾土，宜用发散兼利小便的方法，使其内外的毒邪分消，惊搐自然平息。发散方用消毒饮加防风、川羌活、煨天麻、木通、小草、甘草、钩藤、陈皮、青皮。后期加大黄、麦冬、柴胡、山栀，或者使用清解散。药物包括防风、荆芥、蝉蜕、桔梗、前胡、川芎、升麻、黄芩、木通、牛大力、连翘。治法应当以平抑肝木、利小便为关键。泻肝则风去，利小便则心热清。这是因为心火炽盛，肺金受克不能制约肝木，以致火与风相互搏结，神志不得安宁，待邪火退去，正气旺盛，则心肝安宁而惊搐停止。治疗惊搐只利于关节通畅，不要单纯按惊证治疗，必须清解烦热、安神，适宜疏风、消食、透毒的方法。
Vomiting is caused by Stomach Fire. When Stomach Fire rushes upward, it causes vomiting and an inability to swallow food. Coughing with reverse flow of Qi (Ke Ni) is caused by Lung Fire. When Lung Fire rushes upward, it causes incessant coughing and reverse flow of Qi. The *Classic* states: Vomiting indicates that pathogenic factors are excessive in the upper jiao. By following the Qi mechanism and clearing the fire, the symptoms will cease spontaneously. One must absolutely avoid using ginger juice. If there is phlegm in the diaphragm or meridians, emesis (induced vomiting) is necessary, as emesis also contains the meaning of dispersing outward. This corresponds to what the *Classic* says: "For those high up, use the method of making them vomit out" (*Yin Qi Gao Zhe Yin Er Yue Zhi*).
For persistent vomiting, administer decoction of Puerariae Radix (Gegen). However, this cannot descend Qi or resolve phlegm. For persistent dry heaving and hiccups, administer decoction of Loquat Leaf (Pipaye), which can stop phlegm-cough and Ke Ni.
Thirst accompanied by frequent drinking is called Upper Xiao (Wasting-Thirst), attributed to Lung Heat, where Heart Fire transfers heat to the Lung. Excessive eating with easy hunger is called Middle Xiao, attributed to Stomach Heat. Thirst accompanied by frequent urination and the presence of fatty substances in urine is called Lower Xiao, attributed to Kidney Heat and deficiency of Kidney Water.
The human body relies on Stomach Qi as its foundation; without food intake, Stomach Qi will inevitably be damaged. This situation arises from excess-heat obstruction. In later stages, heavy use of Gypsum (Shigao) is employed to clear Stomach Fire. If constipation occurs, Rhubarb (Dahuang) must be added. There is no need to worry about excessive coldness, nor about purgatives damaging the Stomach. The *Classic* states: "Among all things, the desire to eat is paramount." The *Classic* also states: "Those who can digest grain prosper; those who cannot digest grain perish." One should understand the various reasons for not eating. Some cases involve heat pathogens invading the Stomach causing anorexia; others involve Stomach deficiency with fire closure causing anorexia. This latter case is undoubtedly not due to Stomach deficiency. Anorexia due to Stomach deficiency presents with a quiet body; anorexia due to Stomach heat presents with irritability and external heat sensation. Additionally, overeating, or phlegm stagnation with Qi constraint, or cold pathogens blocking and generating Stomach heat, all lead to anorexia. It must be noted that overeating can cause the Spleen to fail to transform grains, resulting in fullness and distension.
Heat-toxins invade the Heart. As the Heart is the Sovereign Lord, if suddenly bound by Wind pathogens, sweat cannot be released. The Large and Small Intestines become stagnant, preventing internal circulation of pathogens. Consequently, Heart Fire becomes extremely hyperactive. Metal (Lung) is controlled by Fire and cannot level Wood (Liver). Wood moves and generates Wind to invade Earth (Spleen). Thus, vomiting food is accompanied by eye twitching, cyanotic complexion, head shaking, chaotic Qi, and confusion of spirit, leading to convulsions (Jing Chu). The *Classic* states: When Wood evil is excessive and injures Earth, one should use dispersing methods combined with promoting urination, allowing internal and external toxins to be dispersed separately, so that convulsions will settle naturally. For dispersing, use Decoction for Disinfecting (Xiaodu Yin) plus Saposhnikoviae Radix (Fangfeng), Sichuan Notopterygium Root (Chuan Qiang), Prepared Aconite Lateralis Radix Preparata (Wei Tianma - *Note: Context suggests Tianma/Gastrodia, likely typo in source or specific preparation, usually Gastrodiae Rhizoma*), Uncaria Ramulus cum Uncis (Gouteng), Akebia Caulis (Mutong), Polygonum Aviculare (Xiaocao), Licorice Root (Gancao), Citrus Reticulata Pericarpium (Chenpi), and Green Tangerine Peel (Qingpi). In later stages, add Rheum Palmatum (Dahuang), Ophiopogon Tuber (Maidong), Bupleuri Radix (Chaihu), Gardenia Fruit (Shanzhi), or use Clearing and Resolving Decoction (Qingjie San). Ingredients include Saposhnikoviae Radix (Fangfeng), Schizonepeta Spike (Jingjie), Cicada Slough (Chanyi), Platycodon Root (Jiegeng), Peucedani Radix (Qianhu), Ligusticum Chuanxiong Rhizome (Chuanxiong), Cimicifugae Rhizoma (Shengma), Scutellaria Root (Huangqin), Akebia Caulis (Mutong), Ardisia Crenata Root (Dali), and Forsythia Fruit (Lianqiao). The treatment principle should focus on pacifying Liver Wood and promoting urination. Purging the Liver eliminates wind; promoting urination clears Heart heat. This condition arises because Heart Fire is blazing, Metal is controlled and cannot restrain Wood, leading to a struggle between Fire and Wind, disturbing the Spirit. When pathogenic fire recedes and healthy Qi flourishes, the Heart and Liver calm, and convulsions subside. Treating convulsions should prioritize unblocking joints, rather than treating solely as fright. One must clear vexatious heat and calm the spirit. The beneficial approach is to disperse wind, resolve food stagnation, and vent toxins.